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Updated: Jun 19, 2026
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Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
Inferior scapular notching following encore reverse shoulder prosthesis
1Holy Cross Orthopaedic Institute, Fort Lauderdale, Florida, USA.
Orthopedics
|October 15, 2009
Summary
Inferior scapular notching can occur after reverse shoulder arthroplasty, even with prostheses previously thought to be immune. This complication may develop later than initially expected, highlighting the need for vigilant monitoring.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
Background:
- Inferior scapular notching is a known complication of reverse shoulder arthroplasty (RSA).
- The Encore Reverse Shoulder Prosthesis (RSP) was previously reported without cases of scapular notching.
- The center of rotation (COR) placement is critical in RSA design to prevent notching.
Observation:
- A case of inferior scapular notching is presented with the Encore RSP using an alternative glenosphere.
- This glenosphere had a COR 2 mm lateral to the glenoid, deviating from standard designs.
- Notching was not evident at 1-year but appeared by 2-year follow-up.
Findings:
- The Encore RSP, when used with a glenosphere having a COR near the glenoid, can result in scapular notching.
- Scapular notching in this specific configuration may manifest later than typically observed.
- Sirveaux Grade 2 notching was identified at the 2-year radiographic review.
Implications:
- Surgeons must maintain a high index of suspicion for scapular notching with glenoid-centered COR designs.
- Intermediate and long-term follow-up radiographs are essential for detecting delayed notching.
- This case challenges the assumption of immunity for the Encore RSP under specific implantation conditions.
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